Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Blood is a liquid that flows within blood vessels. It is
constantly in motion as the heart pumps blood through arteries to the different organs and cells of
the body. The blood is returned back to the heart by the veins. Veins are
squeezed when muscles in the body contract and push the blood back to the heart.
Blood clotting is an important mechanism to help the body repair injured
blood vessels. Blood consists of:
red blood cells containing
hemoglobin that
carry oxygen to cells and remove
carbon dioxide (the waste product of metabolism),
white blood cells that fight
infection,
platelets that are part of the clotting process of the body, and
blood plasma, which contains fluid, chemicals and
proteins that are important for
bodily functions.
Complex mechanisms exist in the bloodstream to form
clots where they are needed. If the lining of the blood vessels becomes damaged,
platelets are recruited to the injured area to form an initial plug. These
activated platelets release chemicals that start the clotting cascade, using a series of
clotting factors produced by the body. Ultimately, fibrin is formed, the protein that crosslinks
with itself to form a mesh that makes up the final blood clot.
The medical term for a blood clot is a thrombus (plural=
thrombi). When a
thrombus is formed as part of a normal repair process of the body, there is
little consequence. Unfortunately, there are times when a thrombus (blood clot) will form
when it is not needed, and this can have potentially significant consequences.
What does a blood clot look like?
Picture of a how blood clot is formed
What causes blood clots?
Blood clots form when there is damage to the lining of a
blood vessel, either
an artery or a vein. The damage may be obvious,
such as a laceration, or may occur
on the microscopic level. As well, blood will begin to clot if it stops moving
and becomes stagnant.
Venous thrombosis or blood clots in a vein occur when a person becomes
immobilized and muscles are not contracting to push blood back to the heart.
This stagnant blood begins to form small clots along the walls of the
vein. This initial clot can gradually grow to partially or completely occlude or
block the vein and prevent blood from returning to the heart. An analogy
to this process is a slow moving river. Over time, weeds and algae start to
accumulate along the banks of the river where the water flows more slowly.
Gradually, as the weeds start to grow, they begin to invade the center of the
river because they can withstand the pressure of the oncoming water flow.
Arterial thrombi (blood clots in an artery) occur by a
different mechanism. For those with atherosclerotic disease, plaque deposits
form along the lining of the artery and grow to cause narrowing of the vessel.
This is the disease process that may cause
heart attack, stroke,
or peripheral
artery disease. If a
plaque ruptures, a blood clot can form at the site of that rupture and
can completely or partially occlude the blood flow at that point.
Blood clots in the heart. In
atrial
fibrillation, the atrium or
upper chamber of the heart does not beat in an organized manner. Instead, it
jiggles, and blood tends to become stagnant along the walls of the atrium. Over
time, this may cause small blood clots to form. Clots can also form in the
ventricle after a heart attack when part of the heart muscle is injured and
unable to contract normally. Since the damaged area doesn't contract with the
rest of the heart, blood can start to pool or stagnate, leading to clot
formation.
Blood leaking out of a blood vessel. Blood clots can form when
blood leaks out of a blood vessel. This is very beneficial when a person gets a
cut or scrape wound, because
the clot helps stop further bleeding at the wound site. The clotting mechanism works well following trauma as well.
Broken bones,
sprains and strains, and
nosebleeds all result in bleeding that is controlled by the body's clotting mechanism.
Blood clots causing other medical problems.
Sometimes, normal blood clotting can cause medical problems because of its location. For example, if
bleeding occurs in the urine
from any of a variety of reasons (such as infection, trauma, or tumor) clots may form and prevent the bladder from emptying, causing
urinary retention. Clot formation in the uterus may cause pain when the clots are passed through the cervix and
can lead to vaginal bleeding, either as part of
menstruation or as
abnormal vaginal bleeding (menorrhagia, dysmenorrhea).
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
Rectal bleeding (hematochezia) refers to the passage of bright red blood from the anus. Rectal bleeding may be moderate to severe and most bleeding comes from the colon, rectum, or anus. Common causes include anal fissures, hemorrhoids, diverticulitis, and more.
High blood pressure, also known as hypertension, is a repeatedly
elevated blood pressure exceeding 140 over 90 mmHg -- a systolic pressure above
140 with a diastolic pressure above 90. There are two causes of high blood pressure, primary and secondary. Primary high blood pressure is much more common that secondary and its basic causes or underlying defects are not always known. It is known that a diet high in salt increases the risk for high blood pressure, as well as high cholesterol. Genetic factors are also a primary cause. Secondary high blood pressure is generally caused by another condition such as renal hypertension, tumors, and other conditions. Treatment for high blood pressure is generally lifestyle changes and if necessary, diet.
There are many symptoms involved in the 1st, 2nd and 3rd trimesters of pregnancy. The first early pregnancy symptom is typically a missed period, but others include breast swelling and tenderness, nausea and sometimes vomiting, fatigue and bloating. Second trimester symptoms include backache, weight gain, itching, and possible stretch marks. Third trimester symptoms are additional weight gain, heartburn, hemorrhoids, swelling of the ankles, fingers, and face, breast tenderness, and trouble sleeping. Read more to learn about recommended procedures and tests for each stage of a healthy pregnancy.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Liver disease can be cause by a variety of things including infection (hepatitis), diseases such as gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause; however, common symptoms may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease.
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Deep vein thrombosis (DVT) is a blood clot in a vein located deep in the muscles of the legs, thighs, pelvis (lower torso), or arms. The most common symptoms of a deep vein thrombosis are swelling and pain in the leg that has the blood clot. A DVT is difficult to diagnose without specific tests in which the deep vein system can be examined.
Heart attack happens when a blood clot completely obstructs a coronary
artery supplying blood to the heart muscle. A heart attack can cause chest pain, heart failure, and electrical
instability of the heart.
Cholesterol is naturally produced by the body, and is a building block for cell membranes and hormones. Low-density lipoprotein (LDL) cholesterol is the "bad" cholesterol, conversely, high-density lipoprotein (HDL) cholesterol is the "good" cholesterol. High cholesterol treatment includes lifestyle changes (diet and exercise), and medications such as statins, bile acid resins, and fibric acid derivatives.
Normal vaginal bleeding (menorrhea) occurs through the process of menstruation. Abnormal vaginal bleeding in women who are ovulating regularly most commonly involves excessive, frequent, irregular, or decreased bleeding. Causes of abnormal may arise from a variety of conditions.
Celiac disease is a result of an immune reaction to gluten, a protein found in wheat or related grains and present in many foods that we eat. Celiac disease causes impaired absorption and digestion of nutrients through the small intestine. Signs and symptoms of celiac disease include malabsorbption (diarrhea, foul smelling gas, bloating, and increased amounts of fat in the stool) and malnutrition (weight loss, edema, anemia, bruising easily, neuropathy, and infertility). Treatment for celiac disease is a gluten free diet, and at times if necessary, medications
A hematoma is a collection of blood that is outside a blood vessel. There are different areas where hematomas occur including the inside the skull, scalp, ear, septum, bones, finger and toenails, and intra-abdominal. Treatment for hematomas depend on the type and location of the hematoma.
Stool color is generally brown. When stool color changes, often, an individual becomes concerned. The presence of the bilirubin in bile is generally responsible for stool color. Bilirubin concentration can vary bile color from light yellow to almost black in color. Changes in bilirubin can cause stool to turn green, gray, or clay-like in color. Intestinal bleeding may turn stool black, tarry, red, maroon, or smelly stool. Medication and food may also affect stool color.
Internal bleeding occurs when an artery or vein is damaged and blood to escapes the circulatory system and collects inside the body. Internal bleeding can be caused by a variety of situations such as blunt trauma, deceleration trauma, medications, fractures, and spontaneous bleeding. Treatment of internal bleeding depends on the cause of the bleeding.
Ascites, the accumulation of fluid in the abdominal cavity is most commonly caused by cirrhosis of the liver. Some of the other causes of ascites include portal hypertension, congestive heart failure, blood clots, and pancreatitis. The most common symptoms include increased abdominal girth and size, abdominal bloating, and abdominal pain. Treatment depends on the cause of ascites.
A peptic ulcer is an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related to Helicobacter pylori bacteria in the stomach, use of anti-inflammatory medications, and cigarette smoking.
Thrombocytopenia refers to a decreased number of platelets in the blood. There are many causes of thrombocytopenia such as decreased platelet production (viral infections for example rubella, mumps, chickenpox, hepatitis C, and HIV); increased platelet destruction or consumption (for example sulfonamide antibiotics, heparin, blood transfusions, and lupus); or increased splenic sequestration (enlarged spleen due to conditions for example liver disease, blood cancers, and more). Treatment of thrombocytopenia depends on the cause.
The spleen enlarges if it is asked to do excessive work in filtering or manufacturing blood cells, if there is abnormal blood flow to it, or if it is invaded with abnormal cells or deposits. Symptoms of an enlarged spleen may include weakness and fatigue, easy bleeding, and poor white blood cell function. Treatment of an enlarged spleen is focused toward the cause of the splenomegaly. Surgery may be required to remove the spleen.
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Treatment for type 1 diabetes is with insulin, exercise, and a diabetic diet. Treatment for type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
Peripheral vascular disease (PVD) refers to diseases of the blood vessels (arteries and veins) located outside the heart and brain. While there are many causes of peripheral vascular disease, doctors commonly use the term peripheral vascular disease to refer to peripheral artery disease (peripheral arterial disease, PAD), a condition that develops when the arteries that supply blood to the internal organs, arms, and legs become completely or partially blocked as a result of atherosclerosis. Peripheral artery disease symptoms include: intermittent claudication, rest pain, numbness in the extremities, and more. Treatment for peripheral artery disease include: lifestyle measures, medication, angioplasty, and surgery.
Hydronephrosis is a condition in which the kidney swells, due to a backup of urine. Hydronephrosis generally occurs with another disease.Symptoms of hydronephrosis include nausea, vomiting, urinary tract infection, fever, painful urination, increased urinary frequency and urgency, flank pain, and swelling of the abdomen. Treatment of hydronephrosis depends on the cause.
Heart disease (coronary artery disease) is caused by a buildup of cholesterol deposits in the coronary arteries. Risk factors for heart disease include smoking, high blood pressure, heredity, diabetes, peripheral artery disease, and obesity. Symptoms include chest pain and shortness of breath. There are a variety of tests used to diagnose coronary artery disease. Treatment includes life-style changes, medications, procedures, or surgery.
When a portion of the brain loses blood supply, through a blood clot or embolus, a transient ischemic attack (TIA, mini-stroke) may occur. If the symptoms do not resolve, a stroke most likely has occurred. Symptoms of TIA include: confusion, weakness, lethargy, and loss of function to one side of the body. Risk factors for TIA include vascular disease, smoking, high blood pressure, high cholesterol, and diabetes. Treatment depends upon the severity of the TIA, and whether it resolves.
Wisdom teeth are the third set of molars that people get in their late teens or early twenties. Impacted wisdom teeth that only partially erupt allows for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Before your wisdom teeth are pulled, the teeth and the surrounding tissue will be numbed with a local anesthetic. Recovery from wisdom tooth removal depends upon the difficulty of the extraction.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Phlebitis is the inflammation of a vein. Thrombophlebitis is when a blood clot causes the inflammation. Phlebitis can be superficial or deeper in the veins. A blood clot deep in a vein is deep vein thrombosis (DVT). Some of the common causes of phlebitis include prolonged inactivity, varicose veins, trauma to a vein, underlying cancers, clotting disorders, etc. Symptoms of phlebitis may be mild (pain, tenderness, redness, or bulging of a vein. Treatment of phlebitis depends on the cause.
In the United States, head injuries are one of the most common causes of death and disability. Head injuries due to bleeding are generally classified by the location of the blood within the scull, these include: epidural hematoma, subdural hematoma, subarachnoid bleed, intracranial bleed, sheer injury, edema, and skull fracture. Some common symptoms of a head injury include: vomiting, bleeding from the ear, speech difficulties, paralysis, difficulty swallowing, and body numbness. Treatment of a head injury depends on the type and severity of the injury.
Ascites is the accumulation of fluid (usually serous
fluid which is a pale yellow and clear fluid) in the abdominal (peritoneal) cavity. The
abdominal cavity is located below the chest cavity, separated from it by the
diaphragm.
Ascitic fluid can have many sources such as liver disease,
cancers, congestive heart failure, or kidney failure.
What causes ascites?
The most common cause of ascites is advanced liver
disease or cirrhosis. Approximately 80% of the ascites cases are thought to be
due to cirrhosis. Although the exact mechanism of ascites development is not
completely understood, most theories suggest
portal hypertension (increased
pressure in the liver blood flow) as the main contributor. The basic principle
is similar to the formation of edema elsewhere in the body due to an imbalance
of pressure between inside the circulation (high pressure system) and outside, in this case, the
abdominal...